The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain

Abstract

Chronic pain after tissue trauma is frequent and may have a lasting impact on the functioning and quality of life of the affected person. Despite this, chronic postsurgical and posttraumatic pain is underrecognised and, consequently, undertreated. It is not represented in the current International Classification of Diseases (ICD-10). This article describes the new classification of chronic postsurgical and posttraumatic pain for ICD-11. Chronic postsurgical or posttraumatic pain is defined as chronic pain that develops or increases in intensity after a surgical procedure or a tissue injury and persists beyond the healing process, ie, at least 3 months after the surgery or tissue trauma. In the classification, it is distinguished between tissue trauma arising from a controlled procedure in the delivery of health care (surgery) and forms of uncontrolled accidental damage (other traumas). In both sections, the most frequent conditions are included. This provides diagnostic codes for chronic pain conditions that persist after the initial tissue trauma has healed and that require specific treatment and management. It is expected that the representation of chronic postsurgical and posttraumatic pain in ICD-11 furthers identification, diagnosis, and treatment of these pain states. Even more importantly, it will make the diagnosis of chronic posttraumatic or postsurgical pain statistically visible and, it is hoped, stimulate research into these pain syndromes.

Therapeutic Approaches for Peripheral and Central Neuropathic Pain

“…This type of pain originates from peripheral nerve lesions and can be recurrent or persistent [4]. Based on the latest classification, “chronic NP after peripheral nerve injury” is a third-level diagnosis of the “chronic NP” group and can also be derived from “chronic posttraumatic pain,” an additional parent [4, 15]. In addition, many disorders listed in the “chronic postsurgical pain” category can be associated with neuropathic component.…”

“…Chronic postsurgical pain develops after a surgical procedure. Disorders related to this special pain type are the following: chronic pain after amputation, chronic pain after spinal surgery, chronic pain after thoracotomy, chronic pain after breast surgery, chronic pain after herniotomy, chronic pain after hysterectomy, and chronic pain after arthroplasty [15]. Most of these conditions associate with neuropathic components in about half of the patients, which is reflected also by their therapeutic options.…”

“…(1) Chronic Pain after Amputation . By definition, chronic pain after amputation means that the pain developed after surgical amputation of a body part (e.g., limb, breast, tongue, teeth, genitalia, eye, or rectum) [15]. The most common localization of chronic pain after amputation is the distal part of the amputated limb (i.e., stump or phantom limb pain).…”

The incidence of chronic pain following Cesarean section and associated risk factors: A cohort of women followed up for three months

“…In women submitted to Cesarean section, CPSP may exert a negative effect on activities of daily living [ 5 , 13 ] and quality of life [ 7 ], thus representing an important clinical problem. Consequently, the World Health Organization has included CPSP in the new International Classification of Diseases (ICD-11) [ 16 ].…”

A Systematic Review of the Effectiveness of Rehabilitation Therapy to Treat People with Chronic Knee Pain Following A Total Knee Replacement.

“…Chronic pain is de ned as pain persisting or recurring for 3 months or longer, a time period thought su cient for adequate tissue healing 7,8 . Its presence after a total knee replacement is associated with reduced function, poor sleep and psychological health 9,10 , reduced quality of life 11 and ongoing use of medications such as NSAIDS or opioids 12 .…”